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Hyperuricemia and Hypertension: Links and Risks

Douglas J Stewart1, Valerie Langlois1,2, Damien Noone1,2

  • 1Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada.

Integrated Blood Pressure Control
|January 11, 2020
PubMed

Insights

High uric acid levels (hyperuricemia) are linked to cardiovascular risks, especially hypertension in adolescents. More research is needed to confirm causality and the effectiveness of uric acid-lowering therapies.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Metabolic Disorders

Background:

  • Hyperuricemia is associated with increased cardiovascular risk, particularly hypertension.
  • This link appears stronger in pediatric populations.
  • Uric acid's dual role as an extracellular antioxidant and intracellular pro-inflammatory agent contributes to microvascular injury.

Purpose of the Study:

  • To review current data on the relationship between hyperuricemia and hypertension.
  • To highlight the need for robust prospective studies.
  • To assess the current evidence for uric acid-lowering therapies in hypertension prevention.

Main Methods:

  • Review of existing epidemiological and clinical studies.
  • Analysis of proposed mechanisms linking uric acid to hypertension.
  • Identification of research gaps and limitations.

Main Results:

  • Chronic hyperuricemia may lead to microvascular injury and afferent arteriolopathy, contributing to resistant hypertension.
  • Establishing direct causality is challenging due to confounding factors like body mass index.
  • Current evidence supporting uric acid-lowering therapies for hypertension risk mitigation is limited.

Conclusions:

  • Further large-scale prospective randomized controlled trials are essential to establish causality and therapeutic efficacy.
  • The role of hyperuricemia in hypertension requires more definitive investigation.
  • Current data does not strongly support using uric acid-lowering therapies to prevent hypertension.

Keywords:
cardiovascularchronic kidney diseasehypertensionhyperuricemiaurate

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